Measures of Sexual Minority Status and Suicide Risk among Young Adults in the United States


Objectives: Multiple measures of sexual minority status are necessary to accurately describe the diversity of attractions, identities, and behaviors in sexual minority populations. We investigated whether four measures of sexual minority status (sexual minority attraction, sexual minority identity, sexual minority lifetime behavior, and sexual minority recent 12-month behavior) were associated with suicidal thoughts and suicide attempts among young adults ages 24 to 34 in the United States. Methods: We analyzed data from Wave IV (2007-2008) of the National Longitudinal Study of Adolescent Health. We employed logistic regression models in the analysis. Results: Multiple sexual minority status measures had significant associations with increased suicidal thoughts among women and men. Multiple sexual minority status measures had significant associations with increased suicide attempts among women, but not among men. Conclusions: Diverse sexual minority populations are at increased risk for suicidal thoughts and suicide attempts. Multiple measures of sexual minority status should be utilized in future studies of sexual minority status and suicide risk. Suicide prevention programs should ensure intervention is available across diverse sexual minority populations.

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Available from: Michael E Roettger, Sep 07, 2015
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    • "A clear majority of studies reported larger effects among men, compared to women (Almeida, et al., 2009; Cochran, et al., 2007; de Graaf, et al., 2006; Hidaka, et al., 2008; Husky, et al., 2013; Lucassen, et al., 2014; O'Connor, et al., 2014; O'Connor, et al., 2009b; Olshen, et al., 2007; Pinhey & Millman, 2004; Remafedi, et al., 1998; Saewyc, et al., 2007; Skegg, et al., 2003); only one study reported an opposite effect (Almazan, et al., 2014). "
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    ABSTRACT: Many studies, reviews, and meta-analyses have reported elevated mental health problems for sexual minority (SM) individuals. This systematic review provides an update by including numerous recent studies, and explores whether SM individuals are at increased risk across selected mental health problems as per dimensions of sexual orientation (SO), genders, life-stages, geographic regions, and in higher quality studies. A systematic search in PubMed produced 199 studies appropriate for review. A clear majority of studies reported elevated risks for depression, anxiety, suicide attempts or suicides, and substance-related problems for SM men and women, as adolescents or adults from many geographic regions, and with varied SO dimensions (behaviour, attraction, identity), especially in more recent and higher quality studies. One notable exception is alcohol-related problems, where many studies reported zero or reversed effects, especially for SM men. All SM subgroups were at increased risk, but bisexual individuals were at highest risk in the majority of studies. Other subgroup and gender differences are more complex and are discussed. The review supports the long-standing mental health risk proposition for SM individuals, overall and as subgroups.
    Full-text · Article · Nov 2015 · International Review of Psychiatry
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    • "Most studies have assessed sexual minority status using one or more of three criteria; sexual behavior, sexual attraction, or sexual orientation identity [9]. For example, using a nationally representative sample of young adults and four measures of sexual minority status (i.e., sexual attraction, sexual identity, lifetime sexual behavior, past year sexual behavior), Almazan and colleagues [3] assessed suicidal ideation and attempts in association with sexual minority status. All four measures were related to increased risk of suicidal ideation for both male and female individuals. "
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    ABSTRACT: Objective: Despite consistently greater rates of non-suicidal self-injury (NSSI) and suicidal thoughts and behaviors (STBs; i.e., suicidal ideation, method/plan, and attempts) in lesbian, gay, and bisexual (LGB) individuals, prevalence, characteristics, and relations between these dangerous thoughts and behaviors are equivocal. The present study sought to examine and compare the rates of NSSI and STBs in a large sample of sexual minority and majority young adults. In addition, this study is the first to our knowledge to examine how different NSSI characteristics (i.e., frequency, number of forms, and number of functions) relate to STBs of varying severity by sexual attraction (SA). Methods: Participants were 12,422 college students (ages 18-29; 57.3% female) who self-reported demographic characteristics, NSSI frequency, the number of NSSI forms used, the number of NSSI functions, as well as STB history (i.e., ideation, method/plan, and attempts). Each participant’s degree of SA was assessed via a 7-point scale (i.e., K0-K6) from Alfred Kinsey’s research of sexual attraction and sexual experiences. This scale was collapsed to create five categories of SA: exclusively other SA (K0), mostly other SA (K1/2), equally other and same SA (K3), mostly same SA (K4/5), and exclusively same SA (K6). Respondents who chose two or more groups were categorized as having equally other and same SA (K3). Results: Consistent with previous research, we found that being a sexual minority young adult was associated with significantly higher odds of STBs compared to being a heterosexual young adult. In addition, compared to the exclusively other SA group (K0), being in the mostly other SA group (K1/2), equally other and same SA group (K3), or mostly same SA group (K4/5) was associated with significantly higher odds of NSSI engagement. Among those with NSSI, we found that the number of NSSI forms was significantly associated with suicide attempts, but was not associated with either suicidal ideation or suicide method/plan in the mostly other SA group (K1/2) or in the equally other and same SA group (K3). We also found a significant curvilinear relation between NSSI frequency and STBs in the mostly other SA group (K1/2) and between NSSI frequency and suicide method/plan and attempt in the exclusively other SA group (K0). In addition, we revealed specificity with regard to the relation between the number of lifetime NSSI episodes and risk for STBs among the equally other and same SA (K3), mostly same SA (K4/5), and exclusively same SA (K6) groups. Conclusion: Our findings suggest that among sexual minority young adults, equally other and same SA individuals may be at higher risk of NSSI and STBs than their sexual minority counterparts. In addition, our findings extend previous research by suggesting that the relation between NSSI frequency, number of forms, and number of functions and STBs might vary according to SA. A multi-theory based explanation is provided to explain the key findings and the study implications are discussed.
    Full-text · Article · Sep 2015 · Comprehensive psychiatry
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    ABSTRACT: Sexual minority college students (i.e., those not identifying as heterosexual, or those reporting same-sex sexual activity) may be at increased risk of poor mental health, given factors such as minority stress, stigma, and discrimination. Such disparities could have important implications for students' academic achievement, future health, and social functioning. This study compares reports of mental disorder diagnoses, stressful life events, and frequent mental distress across five gender-stratified sexual orientation categories. Data were from the 2007-2011 College Student Health Survey, which surveyed a random sample of college students (N=34,324) at 40 Minnesota institutions. Data analysis was conducted in 2013-2014. The prevalence of mental disorder diagnoses, frequent mental distress, and stressful life events were calculated for heterosexual, discordant heterosexual, gay or lesbian, bisexual, and unsure students. Logistic regression models were fit to estimate the association between sexual orientation and mental health outcomes. Lesbian, gay, and bisexual students were more likely to report any mental health disorder diagnosis than were heterosexual students (p<0.05). Lesbian, gay, bisexual, and unsure students were significantly more likely to report frequent mental distress compared to heterosexual students (OR range, 1.6-2.7). All sexual minority groups, with the exception of unsure men, had significantly greater odds of experiencing two or more stressful life events (OR range, 1.3-2.8). Sexual minority college students experience worse mental health than their heterosexual peers. These students may benefit from interventions that target the structural and social causes of these disparities, and individual-level interventions that consider their unique life experiences. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
    No preview · Article · May 2015 · American journal of preventive medicine
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